Remineralization Effects of Silver Fluoride, Silver Diamine Fluoride, and Sodium Fluoride Varnish

Jihyeon Lee,Hwalim Lee,Jongsoo Kim,Joonhaeng Lee,Jongbin Kim,Jisun Shin,Miran Han 대한예방치과학회 2024 International Journal of Clinical Preventive Denti Vol.20 No.1

Objective: This study aimed to compare the remineralization effect of a newly introduced silver fluoride (AgF) agent when applied to dried and saliva-contaminated tooth surfaces with that of silver diamine fluoride (SDF) and sodium fluoride varnish. Methods: Artificial caries were induced on dentin and enamel using bovine incisors. The specimens were divided into four dentin and four enamel groups, and microhardness was measured. The four groups were categorized into control, AF, DF, and NF. In each group, half of the specimens were treated with fluoride agents on dried surfaces, whereas the other half received the agents on saliva-contaminated surfaces. The control group was treated with distilled water. The AF group was treated with Riva Star AquaTM, consisting of AgF (step 1) and potassium iodide (KI, step 2). The DF group was treated withRiva StarTM, containing SDF (step 1) and KI (step 2). The NF group was treated with Fast Release Varnish. After 7 days of pH cycling, the microhardness was measured again to assess the remineralization effects. Results: The AF and DF groups showed a significant increase in microhardness compared to the NF and control groups. There was no statistically significant difference between the AF and DF groups. For dentin caries, there was no statistically significant difference between the dry subgroup and the saliva-contaminated subgroup in the AF and DF groups. Conclusion: The novel AgF agent can be effectively used for remineralization of dentin and enamel carious lesions, despite the presence of saliva contamination in dentin caries.

벤조케인 도포마취제와 메트헤모글로빈혈증 그리고 메틸렌블루

이준행,김종빈,Lee, Joonhaeng,Kim, Jongbin 대한소아치과학회 2018 大韓小兒齒科學會誌 Vol.45 No.3

치과치료 중에 통증을 유발할 수 있는 요소를 차단함으로써 환자의 공포와 두려움을 줄여줄 수 있다. 이를 위해 벤조케인을 함유한 도포마취제가 광범위하게 사용되고 있다. 그러나, 2018년 5월 28일 식품의약품안전처는 의약품 안전 서한을 통해 24개월 미만의 소아 및 영아에서 벤조케인 함유 제제의 사용을 금지하고 그 이상의 경우라 하더라도 메트헤모글로빈혈증(Methemoglobinemia, MHb)의 발생가능성이 있으므로 신중한 사용을 권고하였다. 이는 지난 5월 23일 미국 식품의약국(Food and Drug Administration, FDA)의 권고의 후속 조치로 시행된 것이다. 벤조케인을 함유한 제제를 사용하는 경우, 치과의사는 MHb의 발생가능성을 반드시 고려해야 하며 MHb의 조기 진단과 적절한 조치가 시행될 수 있도록 준비하고 있어야한다. MHb의 치료제는 메틸렌블루가 1930년대부터 이용되고 있다. 치과의사는 메틸렌블루의 적절한 사용법과 용량을 숙지하고, MHb의 조기 진단을 위한 방법과 진단 장비에 익숙해야 한다. 무엇보다도 환자의 안전에 대한 적절한 대비와 훈련이 필요할 것이다. The aim of this review is to introduce about the issue of benzocaine and methemoglobinemia. Through blocking the pain during dental treatment, fear and anxiety of patients will be reduced. Thus, anesthetic agent containing benzocaine is commonly used while controlling the pain of patients during treatment. However, on May 28, 2018, the Ministry of Food and Drug Safety reported a medication safety report about restricting the use of benzocaine-containing agents in infants under 24 months and children. Also, they recommended a cautious use to adolescents and adults to prevent methemoglobinemia (MHb). This report was published due to an advice from Food and Drug Administration (FDA) on May 23, 2018. When using agents containing benzocaine, dentists must consider the probability of MHb and prepare for early diagnosis and appropriate action. Since 1930s, methylene blue is known to cure MHb patients. Therefore, the proper use of methylene blue for emergencies and diagnosis methods for early diagnosis of MHb should be familiar to dentists planning for the use of topical anesthetic agents. Dentists should be trained for emergency situation of MHb caused by the use of benzocaine.

윌리엄스 신드롬 환자의 치과치료를 위한 고려사항

신지선 ( Jisun Shin ),이준행 ( Joonhaeng Lee ) 대한예방치과·구강보건학회 2018 大韓口腔保健學會誌 Vol.42 No.4

Williams syndrome is a rare congenital disorder with various physical abnormalities and characterized by facial, oral, and dental features. Individuals with Williams syndrome typically have eating disorders in the early childhood, which lead to prolonged night feeding. Prolonged night feeding is a risk factor for rampant dental caries. Williams syndrome is caused by the microdeletion of chromosome 7, resulting in elastin deficiency. Elastin is integral to cardiovascular health. Many patients with Williams syndrome have complex cardiovascular abnormalities that must be considered a part of dental management. Complications related to cardiovascular diseases may induce adverse effects such as dangerously elevated blood pressure. This may occur in patients during stressful dental treatment. In addition, characteristics of auditory hyperalgesia and anxiety disorders among patients with William syndrome, complicate receiving routine dental management. Therefore, dental treatment under sedation or general anesthesia may be preferable for patients with Williams syndrome; in particular, patients who are very uncooperative and/or needs extensive dental treatment. A thorough evaluation of each patient’s physical condition is required before making decisions regarding dental treatment. Careful monitoring and preparation for emergencies are very important during and shortly after dental treatment under general anesthesia or sedation. Monitoring is critical until vital signs have stabilized and return to normal. A 28-month-old man diagnosed as having Williams syndrome, visited the Dental Hospital of OO University for the management of rampant dental caries. We reported on the management of this patient who had peripheral pulmonic stenosis, and received dental treatment under general anesthesia. We also reviewed the characteristics of Williams syndrome and discussed considerations for dental treatment under general anesthesia.

Comparative proteomics of Vibrio vulnificus

Park Sun Young,Lee Ah Young,kho Chang Won,Lee Do Hee,cho Sayeon,Rhee JoonHaeng,Choi SangHo,Myung Pyung Keun,Park Byoung Chul 대한약학회 2004 大韓藥學會 總會 및 學術大會 Vol.2004 No.1

타액검사기의 신뢰도 평가

한금아,이준행,Han, Keumah,Lee, Joonhaeng 대한소아치과학회 2018 大韓小兒齒科學會誌 Vol.45 No.3

타액검사기는 방법이 간단하고 단시간 내에 검사를 할 수 있는 장점이 있다. 하지만 타액 채취가 용이하고 장치의 사용이 간단하나 그 결과의 신뢰성에 영향을 미치는 요인에 대해서는 검증해 볼 필요가 있다. 이번 연구는 타액검사기의 측정 결과에 영향을 미칠 수 있는 요인 중 외부변수인 시간적 요인을 분석하기 위해 측정 시간에 따른 검사 결과의 차이를 비교하였다. 또한 내부변수를 파악하기 위해 타액검사기 측정값 사이의 관련성을 분석하였다. 나이, 성별, 질환의 유무에 상관없이 무작위적으로 선정한 20명의 사람들을 대상으로 하여 타액을 채취하였다. 평균 나이는 46.6세였고, 남자 10명, 여자 10명이었다. 채취한 타액을 바로 타액검사기로 측정한 것을 I군으로 하였다. 또한 채취한 타액을 종이컵에서 10분간 공기중에 방치한 후 타액검사기로 측정한 것을 III군으로 하였다. 그리고 I군으로 사용한 것을 30분 후 재 측정하여 II군으로, III군으로 사용한 것을 30분 후 재 측정한 것을 IV군으로 하였다. 실험 결과 cariogenic bacteria, acidity, buffer capacity, blood, leukocyte, protein and ammonia 중 buffer capacity만 제외하고 나머지는 모두 II, IV군에서 유의한 변화가 있었다. 또한 측정값 중 cariogenic bacteria는 leukocyte, protein과 상호관련성이 있었고 buffer capacity는 acidity, protein과, 그리고 protein은 buffer capacity, leukocyte와 연관성이 있었다. 결론적으로 외부변수인 측정 시간에 따른 측정결과 값의 차이는 각각 다르게 나타났으며, 이는 타액검사 시 시간요인의 중요성을 의미하는 것이다. 또한 내부변수인 측정값 간의 상호관계를 이용하여 임상적으로 접근할 경우 그 연관성에 대한 고려가 필요하다. A salivary testing instrument has an advantage that the method is simple and can be performed in a short time. However, it is necessary to verify the factors that affect the reliability of the result, because the device is easy to use and even saliva collection is simple. The aim of this study was to compare the difference of the test results according to the measurement time in order to analyze the time factor of the external variable among the factors that may affect the measurement results of the salivary testing instrument. The relationship between the measured values of the salivary testing instrument to identify the internal variables was analyzed. Saliva was collected from 20 randomly selected patients regardless of age, sex, or diseases. The mean age was 46.6 years, 10 males and 10 females. The saliva collected was directly measured with the salivary testing instrument as group I. The saliva samples were placed in air in a paper cup for 10 minutes, and then measured as group III. Then group I was remeasured after 30 minutes and assigned as group II. Group III was remeasured after 30 minutes and called as group IV. As a result, all of the cariogenic bacteria, acidity, buffer capacity, blood, leukocyte, protein and ammonia, except buffer capacity, showed statistically significant changes in group II and IV. This means that the reliability of the test results is poor if the measurement time is not observed. Cariogenic bacteria were correlated with leukocyte and protein, buffer capacity was related to acidity, protein, and protein was related to buffer capacity and leukocyte. In conclusion, the result according to the measurement time as the external variable was different, which means that time must be strictly monitored when testing saliva. It is also necessary to take into account the relevance of the correlations between the internal variables and the clinical data.

Comparative proteomics of Vibrio vulnificus

Park, Sun Young,Lee, Ah Young,Kho, Chang Won,Lee, Do Hee,Cho, Sayeon,Rhee, JoonHaeng,Choi, SangHo,Myung, Pyung Keun,Park, Byoung Chul 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8

불화나트륨 바니쉬와 요오드화 칼륨이 Silver Diamine Fluoride의 재광화 효과에 미치는 영향

이건호,안준용,김종수,한미란,이준행,신지선,Lee, Kunho,Ahn, Junyong,Kim, Jong Soo,Han, Miran,Lee, Joonhaeng,Shin Jisun 대한소아치과학회 2021 大韓小兒齒科學會誌 Vol.48 No.4

이 연구의 목적은 silver diamine fluoride(SDF)를 도포할 때 불화나트륨(sodium fluoride, NaF) 바니쉬와 요오드화 칼륨(potassium iodide, KI)이 SDF의 재광화 효과에 미치는 영향을 유치의 법랑질 인공 우식 병소에서 미세경도의 변화를 통해 측정하고, 도포 전과 후의 표면 형태를 주사전자현미경(scanning electron microscopy, SEM)을 통해 관찰하여 비교하는 것이다. 발치된 유구치의 인접면에 법랑질 인공 우식병소를 형성하고 비커스 미세경도를 측정한 후, 4개의 군으로 나누어 I군에는 SDF, II군에는 SDF와 NaF 바니쉬, III군에는 SDF와 KI, 그리고 IV군에는 증류수를 처리하였다. 8일 간 pH cycling을 시행한 후 비커스 미세경도를 다시 한번 측정하여 미세경도의 변화량을 계산하였다. 또한 치아 연마 후, 인공 우식 유발 후, 그리고 pH cycling 이후 각 군에 대하여 각각 2개의 시편을 이용하여 SEM를 촬영하여 표면의 형태를 관찰하였다. 연구결과 미세경도는 III군에서 가장 크게 증가했다. I군과 II군 모두 미세경도의 증가를 보였으나 두 군 사이에는 통계학적으로 유의한 차이가 없었다. IV군에서도 미세경도의 증가를 보였으나 그 변화 정도는 가장 적게 나타났다. SEM 관찰 결과 I, II, III군이 우식 유발 직후나 IV군과 비교하여 표면이 더 균일해지고 불규칙성이 감소된 양상을 보였으며, III군에서 무정형의 피막 형태의 침착이 나타났다. 이러한 결과를 종합해 보면 SDF만을 도포한 군과 SDF와 NaF, SDF와 KI를 함께 도포한 경우 모두 표면 형태가 균일해지고 미세경도가 증가하였으며 이와 같은 결과를 기반으로 구강 내의 환경에서도 재광화 효과를 가질 수 있을 것으로 사료되었다. 또한 이 연구의 제한된 조건 하에서 NaF 바니쉬를 사용하였을 때에는 SDF의 재광화 효과를 증가시키지 못했으며, SDF와 KI를 함께 도포한 경우 SDF의 재광화가 효과가 증가되는 결과를 보였으나 추후 실제 구강 내에서의 다양한 상황을 고려한 추가적인 연구가 필요할 것으로 생각된다. The purpose of this study was to compare the effect of sodium fluoride(NaF) varnish and potassium iodide(KI) on remineralization efficacy of silver diamine fluoride(SDF) by measuring microhardness and evaluating surface morphology by scanning electron microscope(SEM). Artificial caries lesions were induced on extracted primary molars and vickers microhardness was measured. Specimens were randomly separated into 4 groups for treatment. The specimens in group I were treated with SDF, group II with NaF varnish after SDF, group III with KI after SDF and group IV with distilled water. After 8 days of pH cycling, vickers microhardness was measured and difference before and after treatment was calculated. For SEM, 2 samples were evaluated respectively after enamel polishing, lesion formation and after pH cycling. Group III showed highest increase in microhardness. Group I showed higher increase in microhardness than Group II but without statistical difference. Group IV showed lowest increase in microhardness value among 4 groups. On SEM image, group I, II and III showed smoother and less irregular surface compared to group IV. Amorphous crystal pellicles were observed in group III. In conclusion, SDF, SDF and NaF, SDF and KI groups showed smoother surface and increase in microhardness suggesting the possibility that remineralization effect might take place in oral conditions. In addition, in limited conditions of this study, applying NaF varnish after SDF did not increase the remineralization efficacy of SDF while KI significantly increased the remineralization efficacy of SDF. However, additional study considering various conditions that might affect demineralization and remineralization in clinical situations need to be conducted.

Trends in behavioral management techniques for dental treatment of patients with autism spectrum disorder: a 10-year retrospective analysis

Gahee Son,Sohee Oh,Jaehee Lee,Saeromi Jun,Jongbin Kim,Jongsoo Kim,Joonhaeng Lee,Miran Han,Jisun Shin The Korean Dental Society of Anesthsiology 2024 Journal of Dental Anesthesia and Pain Medicine Vol.24 No.3

Background: Patients with autism spectrum disorder (ASD) present challenges in dental treatment cooperation owing to deficits in communication skills and social interaction. Behavioral guidance, sedation, and general anesthesia may be employed to ensure the quality of dental care for individuals with ASD. This study aimed to examine the trends in dental treatment for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital, an oral health center for the disabled in the Gyeonggi region, over the past 10 years. Methods: This study utilized the order communication system to gather data on sex, age, cooperation level, number of quadrants treated, and administration of sedation or general anesthesia for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital between January 2013 and December 2022. Results: The total number of patients with ASD increased annually, possibly due to an increase in ASD prevalence and the hospital's designation as a center for disabled oral health. General anesthesia was predominant before 2017, with a shift towards N₂O-O₂ sedation. The most common age group for sedation or general anesthesia was 6-9 years, with a higher prevalence in males than in females. Notably, N₂O-O₂ and midazolam sedation resulted in better cooperation and fewer treated teeth than general anesthesia. Conclusion: This study highlights the evolving trends in dental treatment for individuals with ASD, indicating a shift towards outpatient methods, particularly N₂O-O₂ sedation. The sex distribution aligns with national statistics, emphasizing a higher prevalence of ASD in males than in females. These findings underscore the need for further research to establish evidence-based guidelines for optimal dental care strategies tailored to the unique needs of individuals with ASD.

유구치와 제1대구치에서의 우상치 유병률과 유병률 간의 상관관계

우승희 ( Seunghee Woo ),김종수 ( Jongsoo Kim ),이준행 ( Joonhaeng Lee ),김종빈 ( Jongbin Kim ) 대한예방치과·구강보건학회 2020 大韓口腔保健學會誌 Vol.44 No.4

Objectives: The purpose of this study was to investigate the prevalence of permanent first molar taurodontism and identify the correlation between primary molars and permanent first molar taurodontism. Methods: Among the 10,113 children who underwent panoramic radiography at a dental hospital from January 2010 to December 2019, 685 children (404 boys, 281 girls) were included in this study. Results: Six children (0.8%) and 98 children (14.1%) showed taurodontism of the primary molars and permanent first molar, respectively. All of the children with taurodontism in the primary molars had at least one taurodontism in the permanent first molars. Conclusions: Early diagnosis of taurodontism in primary molars might allow dentists to make treatment plans in accordance with tooth development.

지혈제의 종류에 따른 레진 강화형 글라스아이오노머 시멘트 결합력의 차이

백설아,이준행,김종빈,한미란,김종수,Back, Seolah,Lee, Joonhaeng,Kim, Jongbin,Han, Miran,Kim, Jong Soo 대한소아치과학회 2021 大韓小兒齒科學會誌 Vol.48 No.4

이 연구의 목적은 유치의 상아질면에서 염화알루미늄 지혈제와 황화철 지혈제의 적용이 레진강화형 글라스아이오노머(RMGIC)의 결합에 미치는 영향을 전단결합강도를 통하여 평가하는 것이다. 20개의 우식이 없는 유구치가 이용되었으며 상아질이 노출되도록 시편을 제작하여 지혈제의 종류에 따라 3개의 군으로 분류하였다. I군은 치면에 25% polyacrylic acid(PAA)를 10초간 사용한 군, II군은 21.3% 염화알루미늄 지혈제를 1분간 사용한 뒤 PAA를 10초간 적용한 군, III군은 20% 황화철 지혈제를 1분간 사용한 뒤 PAA를 10초간 적용한 군으로 설정하였다. 각 군당 10개의 시편에 RMGIC를 중합하여 전단결합강도를 측정하였다. 결합강도는 I군이 10.07 ± 1.83 MPa, 2군에서 7.62 ± 0.78 MPa, 3군에서 5.23 ± 0.78 MPa였다. 모든 군의 결합강도는 유의한 차이를 보였다. 이 연구를 통해 염화알루미늄 지혈제, 황화철 지혈제 모두 상아질에서 RMGIC의 전단결합강도를 감소시키며 황화철 지혈제가 염화알루미늄 지혈제보다 RMGIC의 전단 결합강도를 더 많이 감소시키는 것을 알 수 있었다. The purpose of this study was to compare the effect of the hemostatic agent containing aluminum chloride with hemostatic agent containing ferric sulfate on the shear bond strength of resin-modified glass ionomer cement(RMGIC) to dentin in primary tooth. Twenty extracted non-carious human primary teeth were collected in this study. The specimens were cut to expose dentin and polished. The specimens were randomly seperated into 3 groups for treatment; group I: polyacrylic acid(PAA), RMGIC; group II: aluminum chloride, PAA, RMGIC; group III: ferric sulfate, PAA, RMGIC Ten specimens from each group were subjected to shear bond strength test. The mean shear bond strength of each group was as follows: 10.07 ± 1.83 MPa in Group I, 7.62 ± 0.78 MPA in group II, 5.23 ± 0.78 MPa in group III. There were significant differences among all groups(p < 0.001). In conclusion, both aluminum chloride hemostatic agent and ferric sulfate hemostatic agent decreased the shear bond strength of RMGIC to dentin. And ferric sulfate hemostatic agent decreased the shear bond strength of RMGIC more than the aluminium chloride hemostatic agent.